PDF Cigna Managed Care Network Cigna Care Network

Cigna Managed Care Network

Cigna Care Network?

Important plan information for: Northern New England

Offered by: Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company and their affiliates.

Contents

1

Contents

Winter 2013/2014

Introduction

3

Service is at the

Cigna LifeSOURCE Transplant Network

6

heart of

Pre-certification

9

everything we do.

Health Care Professional Compensation

11

Our goal is to

Service Area

12

give you: fast,

How to Read the Physician Listing

15

answers;

responsive

Primary Care Physicians

16

assistance; and

Obstetricians/Gynecologists

64

convenient

Specialists

73

ways

Hospitals

159

to find

Mental Health / Substance Abuse

160

information.

Pharmacies

230

Other Services

232

Index

237

Go to

to create an online

personalized directory.

Introduction

3

Introduction

You choose your doctor. This guide

can help.



WHO WE ARE

Cigna strives to keep you healthy. We are committed to giving you access to information, technology and support in making informed health care decisions.

We are where you are. Cigna has a national presence, but we also have a local focus in most areas. This means local medical directors and health services representatives work to provide you with access to quality care.

WHAT YOU CAN EXPECT

Convenient access to quality health care. Before joining the Cigna network, health care professionals must meet Cigna standards through a process called credentialing. We regularly review credentials to help ensure they continue to meet these standards.

Medical coverage. Your plan includes coverage for diagnosis and treatment of illness and injury, and a program of preventive care to help keep you and your family well.

Responsive customer service. Whether on our website, , by phone when you talk to a representative or through our automated telephone system, you have access to consistent and timely information about your plan ? when it's convenient for you.

ABOUT THIS DIRECTORY

The following pages list the independent doctors and other health care professionals in this area who participate in the Cigna network. You can use this directory to select your Primary Care Physician (PCP) for yourself and each covered member of your family. You can also use it to locate participating specialists, hospitals, and other health care professionals. An updated listing is always available at . You can use our online directory to:

search for participating physicians, hospitals and other health care professionals. download your own personalized directory to have on hand when you need it. find hospital scores for specific conditions/procedures through Cigna "Centers of

Excellence."

The online directory is updated often, so visit it often. For more information, please visit or call Cigna Customer Service at the toll-free number on your Cigna ID card.

PLEASE NOTE: The term "health care professional" includes the term "provider".

4

Introduction

Your PCP serves as a source for advice and direction.

YOUR CIGNA ID CARD

You receive your Cigna ID card after you enroll.

Keep your Cigna ID card with you at all times. Show it whenever you visit a health care professional or facility.

WORKING WITH YOUR DOCTOR

When you choose your Primary Care Physician (PCP) to be your personal physician, you establish and develop a relationship that remains a reassuring part of your plan. Each covered member of your family can choose his or her own PCP.

The PCP serves as a "home base" for basic care ? a source for advice and direction.

Your PCP also coordinates your care - from preventive checkups and routine medical care to specialized care and hospitalizations.

If required as a part of your plan, your PCP will also provide you with referrals to specialists when necessary. See your plan materials to learn whether your plan requires you to have a referral before seeing a specialist.

If your PCP is part of a medical group, you may be required to see a specialist who practices in that group for services to be covered. Check with your PCP or call Cigna Customer Service to learn whether this requirement applies to you.

Referral-free access to OB/GYNs ? As part of your plan, you can visit a participating OB/GYN at any time, without a referral, even if your plan requires referrals to other types of specialists. Please note: If your PCP is part of a medical group you may be required to see an OB/GYN who practices in that group for services to be covered. Check with your PCP or call Cigna Customer Service to learn whether this requirement applies to you.

You can change your PCP at any time, for any reason.

Vermont allows naturopathic doctors to be PCPs, depending on your plan you may be able to choose a naturopathic doctor who is licensed to practice in VT as your PCP. The doctor must be considered an in-network provider who is contracted with Cigna in VT to be covered as a PCP.

When you see a naturopathic doctor as your PCP you'll pay only the PCP copay if your plan has copayments, or the visit will be subject to the (in-network) deductible and/or coinsurance of the medical plan in which you are enrolled. The copay is the amount you pay toward an office visit. The coinsurance is the amount you pay after your plan begins to pay.

If you need help finding a naturopathic doctor in your network or have any questions as to your plan and the appropriate copayment, please contact Customer Service at the number listed on your ID card.

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